Temper Tantrums

Topic Overview

What are temper tantrums?

A temper tantrum is an unplanned, unintentional expression of anger, often with physical and verbal outbursts. It is not an act to get attention, as is commonly thought. During a temper tantrum, children typically cry, yell, and flail their arms and legs. Temper tantrums usually last 30 seconds to 2 minutes and are most intense at the start.

Sometimes temper tantrums last longer and consist of more aggressive behavior, such as hitting, biting, and pinching. If this type of more aggressive behavior becomes common, a behavioral disorder or other health condition may be the cause.

Temper tantrums are most common in children ages 1 to 4 years. But anyone can have a tantrum, even an adult.

Is it normal for my child to have temper tantrums?

Temper tantrums are common, occurring in about 80% of children ages 1 to 4. About 20% of 2-year-olds and 10% of 4-year-olds have daily temper tantrums.¹

Why do children have temper tantrums?

A tantrum is a normal and expected response when something interferes with a young child's attempt to gain independence or to master a skill. For example, a temper tantrum may be triggered when a child becomes frustrated while trying to button a shirt or is told it is time for bed when he or she wants to stay up longer.

Some children are more likely to have temper tantrums than other children. Factors that contribute to a child's tendency to have tantrums include fatigue, the child's age and stage of development, temperament, stress in the child's environment, and whether other behavioral, developmental, or health conditions are present (such as attention deficit hyperactivity disorder [ADHD] or autism). Also, a child may be more likely to have temper tantrums if parents react too strongly to difficult behavior or give in to the child's demands.

How do I deal with temper tantrums?

Ignoring the tantrum behavior and helping a young child learn how to handle and express anger and frustration are usually effective ways to deal with the behavior. Also, paying attention to what triggers tantrums can help you act before a child's emotions escalate beyond the point where he or she can control them.

If your child continues to have frequent temper tantrums after age 3, you may need to use time-outs. A time-out removes the child from the situation, allows him or her time to calm down, and teaches the child that having a temper tantrum is not acceptable behavior. Time-out works best for children who understand why it is being used.

Will my child grow out of having temper tantrums?

Most children gradually learn healthy ways to handle the strong emotions that can lead to temper tantrums. They also usually improve their ability to communicate, become increasingly independent, and recognize the benefits of having these skills. Children who continue to have tantrums after the age of 4 usually need outside help learning to deal with anger. Temper tantrums that continue or start during the school years may be a sign of other issues, including problems with learning or getting along with other children.

Should I see my child's doctor about temper tantrums?

Talk with a doctor if:

• You have concerns about your child's temper tantrums.
• Your child older than 4 years continues to have frequent temper tantrums.
• Your child's temper tantrums escalate into violent behavior that endangers others or results in self-inflicted injuries.
• You have problems handling your child's behavior, especially if you are concerned that you might hurt your child.

Frequently Asked Questions

Symptoms

Usually, temper tantrums last 30 seconds to 2 minutes and are most intense during the first 30 seconds. During a tantrum, a child may:

• Cry, scream, or shout.
• Arch the back or tense the body.
• Flail the arms.

Temper tantrums are most likely to occur when a child is afraid, overtired, or uncomfortable. Breath-holding spells may sometimes occur with tantrums.

Difficult behavior that frequently lasts longer than 15 minutes, occurs more than 3 times a day, or is more aggressive may indicate that a child has a medical, emotional, or social problem that needs attention. These are not considered typical temper tantrums. Difficult behaviors may include:

• Kicking, hitting, biting, scratching, hair pulling, or pinching other people.
• Throwing or breaking things.
• Head-banging or inflicting self-injury.

Although breath-holding alone is not a sign of a health or behavioral problem, it may need evaluation if it occurs with other more violent symptoms.

Exams and Tests

Talk to your doctor if you are concerned about your child's temper tantrums or other difficult behavior. A doctor can assess your child's behavior based on:

• Your descriptions. It may be helpful to keep a record of the temper tantrums for a few days before an office visit.
• A physical exam and medical history. Your child's doctor will examine your child and ask questions to help identify whether temper tantrums are part of normal growth and developmental patterns or if it's possible that other behavioral or medical causes are responsible.

To eliminate other behavioral or emotional problems as the cause, the doctor may also ask you to complete a behavior assessment questionnaire. Sometimes the child's care provider or school teacher is asked to complete a similar form. Preteens and teens may be asked to complete a questionnaire about their perception of their own behaviors. The doctor can use the completed questionnaires to determine whether the child needs professional help and whether you need help dealing with the child's behavior.

If a doctor suspects that your child's temper tantrums are a sign of another disorder, he or she may order tests to check for other illnesses or conditions, such as seizures, learning problems, or attention deficit hyperactivity disorder (ADHD).

Treatment Overview

Most children learn other ways to deal with their anger and other strong emotions as they grow older and do not need medical treatment for temper tantrums. Ignoring the tantrum behavior and helping a young child learn how to handle his or her feelings is most often all that is needed.

Parenting workshops can be helpful for parents of a child who has temper tantrums. These types of programs often help parents become familiar with growth and developmental stages and provide strategies on how to handle difficult behavior.

Medical treatment for temper tantrums may be recommended for children who:

• Have long-lasting and frequent temper tantrums.
• Regularly have temper tantrums after 4 years of age.
• Hurt themselves or become violent.

Talk with a doctor if:

• You have concerns about your child's temper tantrums.
• Your child's temper tantrums frequently last longer than 15 minutes or occur more than 3 times a day.
• Your child's behavior does not improve after 4 years of age.
• Your child hurts himself or herself, other people, or objects during a temper tantrum.
• You have problems handling your child's behavior, especially if you are concerned that you might hurt your child.
• You want help with learning to cope with your feelings during your child's temper tantrums.

Home Treatment

Expect your 1- or 2-year-old to have temper tantrums. In this age group tantrums are a normal part of learning independence and mastery. If your young child has temper tantrums, try the following:

• Ignore the behavior. Sometimes ignoring the tantrum works best, especially since tantrums usually last less than 2 minutes, and attempts to stop a tantrum usually make it worse. When you stop responding to your child's temper tantrums, the behavior may get worse for a few days before it stops. Ignoring some temper tantrums (such as when a child has one because he or she does not want to go to bed, or is kicking, biting, and pinching) may not be possible.
• Praise for calming down. After a tantrum, comfort your child without giving into her or his demands. Tell your child that he or she was out of control and needed time to calm down. Never make fun of or punish a child who has had a temper tantrum. Don't use words like 'bad girl' or 'bad boy' to describe your child during a temper tantrum.
• Acknowledge the feeling. After your child is calm, acknowledge his or her feelings of frustration and anger. You might say, 'I know that you were frustrated because you could not tie your shoes.'
• Teach other ways to handle anger and frustration. Teaching a child different ways to deal with negative emotions may reduce the number of temper tantrums a child has or prevent temper tantrums from getting worse. Offer simple suggestions to help a child learn self-control. For example, encourage your child to use words to express feelings or establish a safe, comfortable, place in the home where your child can go to calm down. Notice and praise good behavior.
• Encourage taking a break from a frustrating activity or redirect the child to a task he or she has already mastered.
• Be a good role model. Children often learn by watching their parents. Set a good example by handling your own frustration calmly.

During a tantrum, you can help your child by:

• Remaining calm.
• Staying where the child can see you, especially if the child is very young.
• Sending the child to his or her room until he or she is calm, if the child is old enough to understand why this is being done.
• Removing any dangerous furniture or objects within the child's reach. If there are too many objects that could hurt the child, you may need to move the child to a safe place. Sometimes you may need to physically hold a younger child to prevent injury.
• Being firm and consistent about what you expect. Do not give in to the child's demands.
• Not trying to reason with the child during the tantrum. Talk calmly to the child if this works for him or her. But don't lecture, threaten, or argue with the child.

Do not be alarmed if the child holds his or her breath. Children often hold their breath during a temper tantrum. They will breathe again automatically, even if they pass out. For more information, see the topic Breath-Holding Spells.

There are some things you can do to help prevent some temper tantrums. You may be able to:

• Distract your child from his or her frustration or take your child away from a situation that is likely to trigger a tantrum. For example, if your child doesn't like to go to bed, about 20 minutes before bedtime talk about a fun activity that is going to occur the next day. Reduce the need to say "no" to your child by childproofing your home. Fewer rules need to be enforced if unsafe or breakable items are kept out of a child's reach or sight.
• Reduce how often temper tantrums occur by giving your child simple choices and by listening to your child's concerns. It also can help to provide a regular and predictable schedule for your child. This is especially true during times that you expect your child may be more prone to temper tantrums, such as when starting a new child care routine. Establish regular times to eat and sleep to help your child to be in a good state of mind.

In general, parents who know what to expect from their child at different ages are better able to help their child grow and develop in a healthy way. Talk with your doctor about how to help your child gain a sense of independence, boost his or her self-confidence, and handle frustration and anger.

If your child harms himself or herself or others during temper tantrums, talk with your doctor about ways to stop these behaviors. Your doctor may suggest that your child be evaluated for a behavior problem.

Using time-out

If your child continues to have temper tantrums as he or she grows older, you may need to use time-outs. Time-out works best for children who understand why it is being used. This usually does not happen until the child is older than 3. A time-out removes the child from the situation, allows him or her time to calm down, and teaches the child that having a temper tantrum is not acceptable behavior.

If you need to use time-out, it will be important for you to take time to be with your child (time-in). Time-in may help reduce your child's frustration and lead to fewer temper tantrums. Time-in is making frequent, brief, physical contact with your child when he or she is behaving as expected. For example, you can pat your child on the head while he or she is playing quietly. This physical touch shows the child that you approve of his or her behavior. Or you can make a comment such as, 'I like it when you sit quietly and look at your books when I am on the phone.'

Other Places To Get Help

Organizations

Related Information

• Breath-Holding Spells
• Depression in Children and Teens
• Growth and Development, Ages 12 to 24 Months
• Growth and Development, Ages 2 to 5 Years
• Phobias
• Social Anxiety Disorder

References

Citations

1. Stein MT (2003). Difficult behavior: Temper tantrums to conduct disorders. In CD Rudolph et al., eds., Rudolph's Pediatrics, 21st ed., pp. 444-450. New York: McGraw-Hill.

Other Works Consulted

• Albrecht SJ, et al. (2003). Common behavioral dilemmas of the school-aged child. Pediatric Clinics of North America, 50: 841-857.

• Boris NW, Dalton R (2007). Disruptive behavioral disorders. In RM Kliegman et al., eds, Nelson Textbook of Pediatrics, 18th ed., pp. 131-133. Philadelphia: Saunders Elsevier.

• Goldson E, Reynolds A (2009). Temper tantrums and breath-holding spells section of Child development and behavior. In WW Hay et al., eds., Current Diagnosis and Treatment: Pediatrics, 19th ed., pp. 88-89. New York: McGraw-Hill.

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